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CVS PHARMACY, INC.
CH011280 DIMOCK COMM HEALTH CENTER
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Covered Entity Details
Entity Name
DIMOCK COMM HEALTH CENTER
Subdivision Name
DIMOCK COMM HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH011280
Entity Address
45 DIMOCK ST
ROXBURY, MA 02119
Grant Number
H80CS00151
Participating Start Date
7/1/2003
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 02112
19 EASTERN AVENUE
DEDHAM, MA 02026
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter Gerondeau, Interim CEO
(617) 442-9667 Ext: 1203
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2021
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